抑郁症患者临床特征与执行功能障碍的相关研究

目的 探讨抑郁症患者临床特征与执行功能的关系.方法 应用自编一般情况调查表、汉密尔顿抑郁量表（HAMD-17）和汉密尔顿焦虑量表（HAMA）、剑桥神经心理自动化成套测试（CANTAB）中的3项测试对31例抑郁症患者（研究组）及31例健康对照（对照组）进行测试,对研究组患者发病次数、病程及HAMD评分与认知指标进行相关分析.结果 研究组快速视觉信息处理（RVP）校正的总正确数、总击中数、击中率及A＇统计量低于对照组,总漏击数高于对照组（P＜0.05）.空间工作记忆（SWM）的策略分、RVP的B＇统计量、校正的总正确数、错误反应概率和总错误数与病程显示出相关性,SWM的策略分与发作次数呈正相关（P=0.017）,SWM组内错误（P =0.027）、首步平均时间（P=0.027）及动态筛查（MOT）平均错误（P=0.038）与HAMD总分相关显著.阻滞因子与MOT平均错误呈负相关、和SWM首步平均时间呈正相关（P＜0.05）,认知障碍因子与MOT平均错误呈负相关（P=0.012）,焦虑/躯体化因子与SWM组间错误呈负相关（P =0.037）.结论 注意控制障碍可能是抑郁症的认知损害特征性指标之一.

Correlation analysis between clinical features and executive functioning impairment in patients with major depression

Objective To explore the relationship between executive functioning impairment and clinical features in patients with major depression. Methods 31 patients with major depression （study group） and 31 healthy controls （control group） were assessed with self-designed general information questionnaire, Hamilton Depression Scale-17 item （HAMD-17）, Hamilton Anxiety Scale （HAMA） and 3 tests of Cambridge Neuropsychological Test Automated Battery （CANTAB） including Motor Screening Test （MOT）, Spatial Working Memory （SWM）, Rapid Visual Information Processing （RVP）. Correlation analysis was performed to detect the correlation between clinical data and cognitive indexes in study group. Results The total correct, total hits, probability of hit and A＇ in RVP in study group were significnalty lower than those in control group. The total misses in RVP in study group was signifienalty higher than that in control group （ P 〈 0.05 ）. The course of disease was correlated with B＇ , corrected totoal correct, probability of false alarm, total false alarms in RVP, as well as with strategy score of SWM. There was significant correlation between strategy score of SWM and frequency of episode （P = 0.017 ）. Total score of HAMD-17 was significantly correlated with errors in SWM （ P = 0.027）, mean time of first response in SWM （ P = 0. 027 ） and mean errors in MOT （P = 0. 038 ）. Factor score of inhibition was significantly negatively correlated with mean errors in MOT, and was significantly positively correlated with mean time of first response in SWM （ P 〈 0.05 ）. Factor score of cognition disorder was significantly negatively correlated with mean errors in MOT （ P = 0. 012 ）, and factor score of anxiety/somatization was significantly negatively correlated with between-groups errors （ P = 0. 037 ）. Conclusion The disturbance of attention controlling maybe one of the characteristics of cognitive impairment in depression.